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SAN J O A Q U IN Environmental Health Department <br /> c- <br /> < ( iNTY <br /> Corrective Action Statement <br /> RE : February 28 , 2023 , Underground Storage Tank inspection report <br /> For each violation listed below , indicate if the violation has been corrected or will be corrected by a certain date . <br /> Also , describe what was done to correct the violation in the space provided below each violation . Submit this <br /> completed form with the Return to Compliance Certification within 30 days of inspection . If you have any questions , <br /> please contact Shewit Woldearegay at (209) 616-3063 or stwoldearegay@sjgov. org . <br /> Facility name : Verizon Business : LDIKCA Submit completed form to : <br /> Facility address : 2500 W Turner Rd SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID : 10403278 ATTN : SHEWIT WOLDEAREGAY <br /> PR0232507 1868 E HAZELTON AVENUE <br /> STOCKTON , CA 95205 <br /> Violation #107 - Failure to submit and maintain complete and current financial responsibility documents . <br /> ® This violation was corrected ❑ This violation will be corrected by ( date) : <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> Updated current financial responsibility documents filed on site <br /> Violation # 114 - Failure to perform line integrity test every 12 months or within 30 days of repair of primary <br /> pipe. <br /> W This violation was corrected ❑ This violation will be corrected by (date) : <br /> ® Supporting documents included <br /> Describe actions taken or will be taken to correct violation : <br /> Line integrity test report submitted to agency on 6/ 13/2022 . 2023 testing will return to annual testing <br /> in the month of May . <br /> Page 2 of 3 <br /> Rev. 9/16/2020 <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 1 T 209 468-3420 I F 209 464-0138 1 www. sjgov. org/EHD <br />